Follow
Share

I am currently working as a nursing assistant in a nursing home. At 3:00 pm I am assigned 12 patients who are all incontinent and wheelchair bound.


I am assigned to change their diapers and pants, transfer them alone and by hand from the bed to the wheelchair and place all of them in their place in the dining room by 4:00 pm.


Wheeling a patient from the bedroom to the dining room takes a minute.


This allows on average 4 minutes for each diaper change and transfer. The patients have little to no mobility, little to no awareness of what’s going on and I am doing this manually alone.


Is this abusive?


I have heard that this nursing home has been flagged for having an abnormally high number of injuries.


If I would arrive a half hour earlier the this would increase the time to 6.5 minutes.


Personally 15 minutes sounds reasonable to me.


Any opinions are welcome.

This question has been closed for answers. Ask a New Question.
Find Care & Housing
It doesn't sound like nearly enough time for the job required, do it well and do it safely.

Is it an abuse of the patient? That depends on the staffer. If you are rushing, rough handling them, putting them in dangerous situations, in order to meet that deadline, then you are at risk of tilting into what would be considered abusive. If you are taking the amount of time you need regardless of how long it takes and taking the heat for being late from your boss, then there is no patient abuse going on.

Is it abusive to the staff? It could be seen as mental abuse of a staffer to force them to choose between providing what they know is their very best patient care and meeting required deadlines in order to keep their job.
Helpful Answer (5)
Report
jacobstein1960 Jul 2019
“If you are rushing, rough handling them, putting them in dangerous situations, in order to meet that deadline, then you are at risk of tilting into what would be considered abusive.”

That’s exactly what’s happening and they’ve found a gang of workers who don’t care.
(1)
Report
I think it is abuse. Not only for the residents but those care givers like you who have to hurry them through like cattle. It is not right. The states pay for the care of the individuals, who are people and to assign 1 person 12 people all on the same need level is negligence. It is so sad that the fast food industry is more important than caring for people. And if no one speaks up for these people who cannot even speak, then it will only get worse. One day they may just lock them up in cages and throw them food. Or more than likely consider them useless and irrelevant and put them down. I have worked in nursing homes and the care has never been what it should be. No one will take care of your loved one like you would.
It is so very sad, the priorities of the world. People care more about animals than humans. I think what you speak of is abuse. But bless you for what you do.
Helpful Answer (4)
Report

I don't think it is in and of itself abusive, but I can certainly see how the impossibility of your task could lead to shortcuts which could lead to neglect and injuries to both the people being cared for and to staff. With a little bit of forethought the previous shift could be starting changes well before you arrive rather than leaving it - no doubt that is what management expects to be happening🙄. I have no words of wisdom for you other than to look to your coworkers for guidance and seek ways to work smarter - perhaps some of the residents could be changed after supper, or they could be lined up together in the halls before you take them to the dining room.
Helpful Answer (4)
Report
jacobstein1960 Jul 2019
One coworker suggested that I arrive a half hour early, on my own time, to get an earlier start.

The other advice I’ve gotten is “JUST HURRY UP AND DO IT!”
(0)
Report
As an in home caretaker for my mom who is cognizant and helpful, I have to stop myself all the time and mentally tell myself, “Slow down..., be patient...”

You are not allowed to do this! You are being required to “Hurry up! Get moving!,” TIMES TWELVE!

It is unreasonable in so many ways! You have too many patients. You’re given too little time. You’re not given any help. Your not taking in account your patient’s disabilities. You’re not given any leeway for mishaps.

Yes! It is a formula for abuse! How else can you get the job done by the standards set forth?

Not only are you doing one of the hardest jobs there is but you are being set up to be a total failure doing it!

It isn’t like a production line where you will work faster the more experience you get. No matter how good you are at your job, you have extenuating circumstances every way you look at it!

I feel sorry for you, yet I’m very glad we are doing well at home.

Charlotte
Helpful Answer (3)
Report

Even assuming that some of the diapers won't need changing, you are

checking their clothing and any continence pad
moving the resident from the bed to the wheelchair. Is there a Hoyer lift? How is this usually done?
wheeling the resident to the dining room
returning to the next resident

I don't see how you could do that in a total of five minutes per resident without, at best, making the resident feel like a battery chicken. Where's the explanation of each step, pause for permission, individual interaction?

Even when I got quite good at it, I couldn't have changed a soiled diaper - and cleared up, and washed my hands - in five minutes. Fifteen, I think you're right, is probably good going.

When you say you're "doing this manually" - if a resident is unable to bear weight, you shouldn't be doing this without proper equipment and/or on your own. It isn't safe.

What does your line manager have to say about any of this?
Helpful Answer (3)
Report
jacobstein1960 Jul 2019
There is no equipment involved whatsoever and no assistance from another person.

I would describe what I see being done as “sack of potatoes” treatment.
(0)
Report
Sorry for my earlier reply, I wasn't paying attention🤔.

If you are rushing through only to have the residents sitting waiting for an hour for their dinners then I'd simply work at your own pace. This sounds like a toxic workplace where management turns a blind eye and your coworkers have gotten used to slacking off, it's why good aides either burn out or quit. Thank goodness for people like you.
Helpful Answer (2)
Report

We need another CNAs opinion. On the whole, 12 patients doesn't seem a lot, in an 8hr shift. But trying to get them all ready to go to dinner...an impossible task. I would question if day shift is responsible for getting the ball rolling. You need to ask your supervisor how are you suppose to accomplish the task. I have heard said on this forum that in transferring two people are needed.
Helpful Answer (1)
Report

Actually I’m looking over the nursing home schedule and there isn’t any really important reason to do it this quickly.

The real reason seems to be that the CNA’s just want to get it over with and have a smoking break.
Helpful Answer (1)
Report
cwillie Jul 2019
I'm not sure what you are trying to say - the OP starts work at 3:00 and is expected to have those in her care seated in the dining room by 4:00. We don't know why they should be in the dining room by 4:00 since that seem early for supper but that is what she is expected to accomplish. If she really didn't give a s**t then she wouldn't have posted.
(0)
Report
See 2 more replies
The transferring from bed to wheelchair sounds horrendously risky for residents and CNAs alike.

If I may say so, you don't write like the kind of person who wouldn't know how to report risks and poor practice if you need to. What do you plan to do?
Helpful Answer (1)
Report

There are laws. In each state about the patient ratio you can have. I would imagine 12 to one is against the law.
Helpful Answer (0)
Report

See All Answers
This question has been closed for answers. Ask a New Question.
Ask a Question
Subscribe to
Our Newsletter